Low-Grade-Infekt

Steinhausen, Eva

doi:10.1007/s10039-017-0297-z

Cited by 6 publications

(1 citation statement)

References 26 publications

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“…The diagnosis of low-grade infection is therefore much more difficult than that of acute infection. Microbiological and histological analyses of tissue samples collected from the nonunion area are the only appropriate way to differentiate between aseptic and septic nonunion caused by low-grade infection [ 18 , 19 ]. This is more critical since the treatment concepts and the surgical management of aseptic and septic nonunion are almost opposite: Reamed intramedullary exchange nailing as a single-step procedure is the treatment of choice for aseptic diaphyseal nonunion of the femur and is combined with a high rate of osseous union [ 20 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes Following Single-Stage Reamed Intramedullary Exchange Nailing in Apparently Aseptic Femoral Shaft Nonunion with Unsuspected Proof of Bacteria

Hackl,

von Rüden,

Trenkwalder

et al. 2024

JCM

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Background: The aim of this study was to evaluate detection rates and risk factors for unsuspected proof of bacteria, as well as clinical and radiologic outcomes following femoral shaft nonunion without clinical signs of infection treated by a single-stage surgical revision procedure including reamed intramedullary exchange nailing. Methods: A retrospective cohort study was performed in a European level I trauma center between January 2015 and December 2022. Fifty-eight patients were included who underwent reamed intramedullary exchange nailing as a single-step procedure for surgical revision of posttraumatic diaphyseal femoral nonunion without any indications of infection in medical history and without clinical signs of local infection. Clinical details of the patients were analyzed and functional and radiologic long-term outcomes were determined. Results: In all patients, with and without proof of bacteria osseous, healing could be observed. The physical component summary of the SF-12 demonstrated significantly better results at least one year after the final surgical revision in case of a negative bacterial culture during exchange nailing. Conclusions: Clinical long-term outcomes demonstrated a trend towards better results following femoral shaft nonunion revision if there was no evidence for the presence of low-grade infected nonunion. In this case, a single-stage surgical procedure may be recommended.

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